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Modified Checklist for Autism in Toddlers Revised (MCHAT-R/F) in an Urban Metropolitan Sample of Young Children in Turkey

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Abstract

The study assessed the feasibility of using a Turkish-version of the Modified Checklist for Autism in Toddlers, Revised (M-CHAT-R/F) as a screening tool for an urban low risk population of young children. M-CHAT-R/F was completed for 6712 children between ages 16 and 36 months living in Istanbul, Turkey. Autism Diagnostic Observation Schedule-2 was served as the main measure for diagnosis. M-CHAT-R/F screen was positive for 9.8% of children. At follow up interview, 39.7% of initial screen-positive children met criteria for ASD. The study identified 57 (1 in 117) children with ASD (0.8%; 95% CI 0.063–1.05%). M-CHAT-R/F performed comparably in Turkey as in United States. Implications of the study for future universal screening for autism in Turkey is also discussed.

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References

  • Al-Qabandi, M., Gorter, J. W., & Rosenbaum, P. (2011). Early autism detection: Are we ready for routine screening? Pediatrics, 128(1), e211–e217.

    Article  PubMed  Google Scholar 

  • American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders. Arlington: American Psychiatric Association.

    Google Scholar 

  • Anlar, B., Bayoglu, B. U., & Yalaz, K. (2009). Denver II Screening Test: Standardization and Adaptation for Turkish Children.

  • Baduel, S., Guillon, Q., Afzali, M. H., Foudon, N., Kruck, J., & Rogé, B. (2017). The French version of the modified-checklist for autism in toddlers (M-CHAT): A validation study on a French sample of 24 month-old children. Journal of Autism and Developmental Disorders, 47(2), 297–304.

    Article  PubMed  Google Scholar 

  • Baio, J., Wiggins, L., Christensen, D. L., Maenner, M. J., Daniels, J., Warren, Z., et al. (2018). Prevalence of Autism spectrum disorder among children aged 8 years - Autism and developmental disabilities monitoring network, 11 Sites, United States, 2014. MMWR Surveillance Summaries, 67(6), 1–23.

    Article  PubMed Central  Google Scholar 

  • Brennan, L., Fein, D., Como, A., Rathwell, I. C., & Chen, C. M. (2016). Use of the modified checklist for autism, revised with follow up-Albanian to screen for ASD in Albania. Journal of Autism and Developmental Disorders, 46(11), 3392–3407.

    Article  PubMed  PubMed Central  Google Scholar 

  • Christensen, D. L., Bilder, D. A., Zahorodny, W., et al. (2016). Prevalence and characteristics of autism spectrum disorder among 4-year-old children in the Autism and Developmental Disabilities Monitoring Network. Journal of Developmental and Behavioral Pediatrics, 37, 1–8.

    Article  PubMed  Google Scholar 

  • Christensen, D. L., Braun, K. V. N., Baio, J., Bilder, D., Charles, J., Constantino, J. N., et al. (2012). Prevalence and characteristics of autism spectrum disorder among children aged 8 years—autism and developmental disabilities monitoring network, 11 Sites. United States. MMWR Surveillance Summaries (2018), 65(13), 1–23.

    Google Scholar 

  • Christensen, D. L., Maenner, M. J., Bilder, D. A., Constantino, J. N., et al. (2019). Prevalence and characteristics of autism spectrum disorder among children aged 4-years- early autism and developmental disabilities monitoring network, seven sites, United States, 2010, 2012 and 2014. MMWR Surveillance Summaries, 68, 1–19.

    Article  PubMed Central  Google Scholar 

  • Council on Children With Disabilities, Section on Developmental Behavioral Pediatrics, Bright Futures Steering Committee, & Medical Home Initiatives for Children With Special Needs Project Advisory Committee. (2006). Identifying infants and young children with developmental disorders in the medical home: An algorithm for developmental surveillance and screening. Pediatrics, 118(1), 405–420.

    Article  Google Scholar 

  • Dawson, G., Rogers, S., Munson, J., Smith, M., Winter, J., Greenson, J., et al. (2010). Randomized, controlled trial of an intervention for toddlers with autism: The early start Denver model. Pediatrics, 125(1), e17–e23.

    Article  PubMed  Google Scholar 

  • Elsabbagh, M., Divan, G., Koh, Y. J., Kim, Y. S., Kauchali, S., Marcín, C., et al. (2012). Global prevalence of autism and other pervasive developmental disorders. Autism Research, 5(3), 160–179.

    Article  PubMed  PubMed Central  Google Scholar 

  • Fenikilé, T. S., Ellerbeck, K., Filippi, M. K., & Daley, C. M. (2015). Barriers to autism screening in family medicine practice: A qualitative study. Primary Health Care Research and Development, 16(4), 356–366.

    Article  PubMed  Google Scholar 

  • Frankenburg, W. K., & Dodds, J. B. (1990). Denver II screening manual. Denver: Denver Developmental Materials, Inc.

    Google Scholar 

  • García-Primo, P., Hellendoorn, A., Charman, T., Roeyers, H., Dereu, M., Roge, B., et al. (2014). Screening for autism spectrum disorders: State of the art in Europe. European Child and Adolescent Psychiatry, 23(11), 1005–1021.

    Article  PubMed  Google Scholar 

  • Guo, C., Luo, M., Wang, X., Huang, S., Meng, Z., Shao, J., et al. (2019). Reliability and validity of the Chinese version of modified checklist for autism in toddlers, revised, with follow-up (M-CHAT-R/F). Journal of Autism and Developmental Disorders, 49(1), 185–196.

    Article  PubMed  Google Scholar 

  • Gupta, V. B., Hyman, S. L., Johnson, C. P., Bryant, J., Byers, B., Kallen, R., et al. (2007). Identifying children with autism early? Pediatrics, 119(1), 152–153.

    Article  PubMed  Google Scholar 

  • Howlin, P., Magiati, I., & Charman, T. (2009). Systematic review of early intensive behavioral interventions for children with autism. American Journal on Intellectual and Developmental Disabilities, 114(1), 23–41.

    Article  PubMed  Google Scholar 

  • Johnson, C. P., & Myers, S. M. (2007). American Academy of Pediatrics Council on Children with Disabilities. Identification and evaluation of children with autism spectrum disorders. Pediatrics, 120, 1183–1215.

    Article  PubMed  Google Scholar 

  • Jöreskog, K. G. (1971). Statistical analysis of sets of congeneric tests. Psychometrika, 36, 109–133.

    Article  Google Scholar 

  • Kamio, Y., Haraguchi, H., Stickley, A., Ogino, K., Ishitobi, M., & Takahashi, H. (2015). Brief report: Best discriminators for identifying children with autism spectrum disorder at an 18-Month Health Check-Up in Japan. Journal of Autism and Developmental Disorders, 45(12), 4147–4153.

    Article  PubMed  PubMed Central  Google Scholar 

  • Khowaja, M. K., Hazzard, A. P., & Robins, D. L. (2015). Sociodemographic barriers to early detection of autism: Screening and evaluation using the M-CHAT, M-CHAT-R, and follow-up. Journal of Autism and Developmental Disorders, 45(6), 1797–1808.

    Article  PubMed  PubMed Central  Google Scholar 

  • Kleinman, J. M., Ventola, P. E., Pandey, J., Verbalis, A. D., Barton, M., Hodgson, S., et al. (2008). Diagnostic stability in very young children with autism spectrum disorders. Journal of Autism and Developmental Disorders, 38(4), 606–615.

    Article  PubMed  Google Scholar 

  • Lord, C., Rutter, M., DiLavore, P. C., Risi, S., Gotham, K., & Bishop, S. L. (2012a). Autism diagnostic observation schedule, second edition (ADOS-2) (Part I): Modules 1-4 torrance. CA: Western Psychological Services.

    Google Scholar 

  • Lord, C., Rutter, M., DiLavore, P. C., Risi, S., Gotham, K., & Bishop, S. L. (2012b). Autism diagnostic observation schedule, second edition (ADOS-2) (Part II): Toddler module torrance. CA: Western Psychological Services.

    Google Scholar 

  • McDonald, R. P. (1999). Test theory: A unified treatment. Mahwah: Lawrence Erlbaum Associates Inc.

    Google Scholar 

  • Munir, K. (2016). Co-occurrence of mental disorders in children and adolescents with intellectual disability/intellectual developmental disorder. Current Opinion in Psychiatry, 29(2), 95–102.

    Article  PubMed  PubMed Central  Google Scholar 

  • Munir, K. M., Lavelle, T. A., Helm, D. T., Thompson, D., Presstt, J., & Azeem, M. W. (2016). Autism: Global framework for action. Doha: World Innovation Summit in Health.

    Google Scholar 

  • National Collaborating Centre for Women’s and Children’s Health (UK). (2011). Autism: Recognition, referral and diagnosis of children and young people on the autism spectrum. London: RCOG Press.

    Google Scholar 

  • Reich, S. (2005). What do mothers know? Maternal knowledge of child development. Infant Mental Health Journal, 26(2), 143–156.

    Article  PubMed  Google Scholar 

  • Robins, D. L., Casagrande, K., Barton, M. L., Chen, C., Dumont- Mathieu, T., & Fein, D. (2014). Validation of the modified checklist for autism in toddlers-revised with follow-up (MCHAT- R/F). Pediatrics, 133(1), 37–45.

    Article  PubMed  PubMed Central  Google Scholar 

  • Robins, D. L., Fein, D., & Barton, M. (2009). The modified checklist for autism in toddlers, revised with follow-up (M-CHAT-R/F).

  • Robins, D. L., Fein, D., Barton, M. L., & Green, J. A. (2001). The modified checklist for autism in toddlers: An initial study investigating the early detection of autism and pervasive developmental disorders. Journal of Autism and Developmental Disorders, 31(2), 131–144.

    Article  PubMed  Google Scholar 

  • Rosenthal, R., & Jacobson, L. (1992). Pygmalion in the classroom: Teacher expectation and pupils’ intellectual development. Bancyfelin: Crown House Pub.

    Google Scholar 

  • Seung, H., Ji, J., Kim, S. J., Sung, I., Youn, Y. A., Hong, G., et al. (2015). Examination of the Korean modified checklist of autism in toddlers: Item response theory. Journal of Autism and Developmental Disorders, 45(9), 2744–2757.

    Article  PubMed  Google Scholar 

  • Silverstein, M., & Radesky, J. (2016). Embrace the complexity: The US Preventive Services Task Force recommendation on screening for autism spectrum disorder. JAMA, 315(7), 661–662.

    Article  PubMed  Google Scholar 

  • Siu, A. L., Bibbins-Domingo, K., Grossman, D. C., Baumann, L. C., Davidson, K. W., Ebell, M., et al. (2016). Screening for autism spectrum disorder in young children. Journal of American Medical Association, 315(7), 691.

    Article  Google Scholar 

  • Srisinghasongkram, P., Pruksananonda, C., & Chonchaiya, W. (2016). Two-step screening of the modified checklist for autism in toddlers in Thai children with language delay and typically developing children. Journal of Autism and Developmental Disorders, 46(10), 3317–3329.

    Article  PubMed  Google Scholar 

  • Stenberg, N., Bresnahan, M., Gunnes, N., Hirtz, D., Hornig, M., Lie, K. K., et al. (2014). Identifying children with autism spectrum disorder at 18 months in a general population sample. Paediatric and Perinatal Epidemiology, 28(3), 255–262.

    Article  PubMed  PubMed Central  Google Scholar 

  • Stone, L. S., Janssens, J. M. A. M., Vermulst, A. A., Van Der Maten, M., Engels, R. C. M. E., & Otten, R. (2015). The Strengths and Difficulties Questionnaire: Psychometric properties of the parents and tacher version in children aged 4-7. BMC Psychol, 3, 4.

    Article  PubMed  PubMed Central  Google Scholar 

  • Thompson, T. (2013). Autism research and services for young children: History, progress and challenges. Journal of Applied Research in Intellectual Disabilities, 26(2), 81–107.

    Article  PubMed  Google Scholar 

  • Tsai, J. M., Lu, L., Jeng, S. F., Cheong, P. L., Gau, S. S., Huang, Y. H., et al. (2019). Validation of the modified checklist for autism in toddlers, revised with follow-up in Taiwanese toddlers. Research in Developmental Disabilities, 85, 205–216.

    Article  PubMed  Google Scholar 

  • Zwaigenbaum, L., Bauman, M. L., Fein, D., Pierce, K., Buie, T., Davis, P. A., et al. (2015). Early Screening of Autism Spectrum Disorder: Recommendations for practice and research. Pediatrics, 136(Suppl 1), 41–59.

    Article  Google Scholar 

  • Zwaigenbaum, L., Bryson, S., & Garon, N. (2013). Early identification of autism spectrum disorders. Behavioural Brain Research, 251, 133–146.

    Article  PubMed  Google Scholar 

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Acknowledgments

Drs. Ozgur Oner and Kerim Munir were supported, in part, by Fogarty International Center/NIMH Grant No. (D43TW009680) at Boston Children’s Hospital. We also like to thank Betül Yıldırım, Betul Olgun, Cansu Tacı, Fulin Kurtkaya, Betul Selcen Ozer, Ozgul Gurel, Selcen Keskin Oner, psychologists, physicians, nurses, and families that took part in the study.

Author Contributions

Dr. Oner designed the study, collected and analyzed data, drafted the manuscript and revised it. Dr. Munir contributed to conceptualization, data analysis, discussion of findings, revision of the first draft and other versions of the manuscript.

Funding

This study was funded by İstanbul Kalkinma Ajansi (ISTKA).

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Authors and Affiliations

  1. Department of Child Psychiatry, Bahcesehir University School of Medicine, Istanbul, Turkey

    Ozgur Oner

  2. Boston Children’s Hospital, Harvard Medical School, Boston, MA, USA

    Kerim M. Munir

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  1. Ozgur Oner
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Correspondence to Ozgur Oner.

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Oner, O., Munir, K.M. Modified Checklist for Autism in Toddlers Revised (MCHAT-R/F) in an Urban Metropolitan Sample of Young Children in Turkey. J Autism Dev Disord 50, 3312–3319 (2020). https://doi.org/10.1007/s10803-019-04160-4

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